Background/Aims: Cardiovascular disease is the most prominent cause of mortality worldwide. A key risk factor for atherosclerotic cardiovascular disease is the presence of dyslipidemia. Clinical approaches to evaluation and treatment of dyslipidemia in children and adolescents are presented. Methods: A review of published guidelines and presentation of illustrative cases. Results: Dyslipidemia is an important risk factor in early-stage atherosclerosis. Children and adolescents at high risk for dyslipidemia can be identified using a positive family history or the presence of other risk factors as a trigger. Once high-risk individuals are identified, primary treatment is lifestyle modification. In cases where low-density lipoprotein-cholesterol is high, pharmacologic intervention may be needed. Conclusions: Screening of appropriate children and adolescents for dyslipidemia and treating those at high risk are important for the long-term prevention of cardiovascular disease.

Journal Section:
Pediatric Meet the Professor
Keywords:
Adolescents, Cardiovascular disease, Children, Cholesterol, Dyslipidemia, Obesity
1.
Berenson GS, Srinisvasan SR, Bao W, Newman WP III, Tracy RE, Wattigney WA: Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults: the Bogalusa Heart Study. N Engl J Med 1998;338:1650–1656.
[PubMed]
https://doi.org/10.1056%2FNEJM199806043382302
2.
Relationship of atherosclerosis in young men to serum lipoprotein cholesterol concentrations and smoking: a preliminary report from the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. JAMA 1990;264:3018–3024.
https://doi.org/10.1001%2Fjama.264.23.3018
3.
Wilson PWF, Castelli WP, Kannel WB: Coronary risk prediction in adults (the Framingham Heart Study). Am J Cardiol 1987;59:91G–94G.
https://doi.org/10.1016%2F0002-9149%2887%2990165-2
4.
American Academy of Pediatrics: National Cholesterol Education Program: report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics 1992;89:525–584.
[PubMed]
5.
Kavey RE, Allada V, Daniels SR, Hayman LL, McCrindle BW, Newburger JW, Parekh RS, Steinberger J; American Heart Association Expert Panel on Population and Prevention Science; American Heart Association Council on Cardiovascular Disease in the Young; American Heart Association Council on Epidemiology and Prevention; American Heart Association Council on Nutrition, Physical Activity and Metabolism; American Heart Association Council on High Blood Pressure Research; American Heart Association Council on Cardiovascular Nursing; American Heart Association Council on the Kidney in Heart Disease; Interdisciplinary Working Group on Quality of Care and Outcomes Research: Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research, endorsed by the American Academy of Pediatrics. Circulation 2006;114:2710–2738.
https://doi.org/10.1161%2FCIRCULATIONAHA.106.179568
6.
McCrindle BW, Urbina EM, Dennison BA, Jacobson MS, Steinberger J, Rocchini AP, Hayman LL, Daniels SR; American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee; American Heart Association Council of Cardiovascular Disease in the Young; American Heart Association Council on Cardiovascular Nursing: Drug therapy for high-risk lipid abnormalities in children and adolescents: a scientific statement from the American Heart Association Atherosclerosis, Hypertension and Obesity in Youth Committee, Council of Cardiovascular Disease in the Young, with the Council on Cardiovascular Nursing. Circulation 2007;115:1948–1967.
[PubMed]
https://doi.org/10.1161%2FCIRCULATIONAHA.107.181946
7.
Daniels SR, Greer FR; Committee on Nutrition: Lipid screening and cardiovascular health in childhood. Pediatrics 2008;122:198–208.
[PubMed]
https://doi.org/10.1542%2Fpeds.2008-1349
8.
American Diabetes Association: Management of dyslipidemia in children and adolescents with diabetes. Diabetes Care 2003;26:2194–2197.
[PubMed]
https://doi.org/10.2337%2Fdiacare.26.7.2194
9.
Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM: Prevalence of overweight and obesity in the United States. 1999–2004. JAMA 2006;295:1549–1555.
[PubMed]
https://doi.org/10.1001%2Fjama.295.13.1549
10.
Wiegman A, Hutten BA, de Groot E, Rodenburg J, Bakker HD, Buller HR, Sijbrands EJ, Kastelein JJ: Efficacy and safety of statin therapy in children with familial hypercholesterolemia: a randomized controlled trial. JAMA 2004;292:331–337.
https://doi.org/10.1001%2Fjama.292.3.331
11.
Steinberger J, Daniels SR, Eckel RH, Hayman L, Lustig RH, McCrindle B, Mietus-Snyder ML; American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity and Metabolism: Progress and challenges in metabolic syndrome in children and adolescents: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity and Metabolism. Circulation 2009;119:628–647.
12.
Franz MJ, Bantle JP, Beede CA, Brunzell JD, Chiasson JL, Garg A, Holzmeister LA, Hoogwerf B, Mayer-Davis E, Mooradian AD, Purnell JQ, Wheeler M; American Diabetes Association: Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 2003;26(suppl 1): S51–S61.
13.
Bantle JP, Wylie-Rosett J, Albright AL, Apovian CM, Clark NG, Franz MJ, Hoogwerf BJ, Lichtenstein AH, Mayer-Davis E, Mooradian AD, Wheeler ML: Nutrition recommendations and interventions for diabetes, 2006: a position statement of the American Diabetes Association. Diabetes Care 2006;29:2140–2157.
https://doi.org/10.2337%2Fdc06-9914
© 2011 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2011
You do not currently have access to this content.